MONOBACTIM ANTIBIOTICS

NAME OF DRUG MECHANISM OF ACTION INDICATIONS AND NURSING RESPONSIBILITIES

CONTRAINDICATIONS/ ADVERSE
EFFECTS
 Inhibits bacterial cell wall  Obtain culture and sensitivity test
Drug Name: synthesis in susceptible aerobic Indications: results, if possible, before starting
 aztreonam gram-negative bacteria. These  To treat infections ofthe urinary aztreonam therapy. If patient is
bacteria assemble rigid, cross- tract, lower respiratory tract, acutely ill, expect to begin
Generic Name: linked cell walls in several skin, soft tissue, female therapy before results are
 aztreonam steps.Aztreonam affects the final reproductive tract; intra- available.
cross-linking step by inactivating abdominal infections; septicemia;  Keep in mind that other
Classification: penicillin-binding protein 3 (the and surgical abscesses caused by antimicrobials may be used with
 Antibiotic enzyme that links cell wall susceptible strains of gram- aztreonam in seriously ill patients
strands), which causes cell lysis negative bacteria at risk for gram-positive infection.
Dosage and Frequency: and death.  Expect to use I.V. route for
 Adults.0.5 to 2 g every 8 to 12 hr Contraindications: patients who need single doses
to maximum of 8 g daily. For life-  Hypersensitivity to aztreonam or over 1 g and those with life-
threatening systemic infection, 2 its components threatening systemic infections,
g every 6 to 8 hr to maximum of 8 such as septicemia or peritonitis.
g daily. Children ages 9 months to Adverse Reactions:  To reconstitute aztreonam for I.V.
16 years. 30 mg/kg every 6 to 8  CNS: Confusion, dizziness, fever, bolus injection, use sterile water
hr up to 120 mg/kg headache, insomnia, malaise, for injection.
paresthesia, seizures, vertigo  Immediately after adding diluent
Route:  CV: Chest pain, hypotension, to vial, shake it vigorously to mix.
 IM and IV transient ECG changes After obtaining correct dose,
 EENT: Altered taste, diplopia, discard unused solution.
halitosis, mouth ulcers,  Reconstituted solution may turn
mucocutaneous candidiasis,nasal light pink on standing at room
congestion, sneezing, tinnitus, temperature. This doesn’t affect
tongue numbness drug potency.
 GI: Abdominal cramps, diarrhea,  Give I.V. bolus injection directly
elevated liver function test into I.V. tubing over 3 to 5
results, GI bleeding, hepatitis, minutes.
nausea, pseudomembranous
colitis, vomiting
 GU: Breast tenderness, elevated
serum creatinine level, vaginal
candidiasis
 HEME: Anemia, eosinophilia,
leukocytosis, neutropenia,
pancytopenia, positive Coombs’
test, prolonged PT and APTT,
thrombocytopenia,
thrombocytosis MS: Myalgia
 RESP: Bronchospasm, dyspnea,
wheezing
 SKIN: Diaphoresis, erythema
multiforme, exfoliative
dermatitis, flushing, jaundice,
petechiae, pruritus, purpura,
rash, toxic epidermal necrolysis,
urticaria
 Other:Allergic reaction; injection
site pain, phlebitis, swelling, or
thrombophlebitis